ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024
Multielectrode catheter-based pulsed field ablation of persistent and long-standing persistent atrial fibrillation.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pulsed-Field Ablation for Persistent Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of cardiovascular electrophysiology · 2026Pooled it
- Standardised superior vena cava isolation with a balloon-in-basket pulsed-field ablation catheter: feasibility and acute safety of two procedural workflows in 53 consecutive patients.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Hybrid Thoracoscopic-Endocardial Versus Endocardial Catheter Ablation for Persistent Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2026Article
- The Finding of Posterior Wall Low-Voltage Zones During Cryoballoon Pulmonary Vein Isolation Facilitated by Periprocedural Electroanatomical Mapping Is Associated with a Worse Ablation Outcome.Journal of cardiovascular development and disease · 2026Article
- Predictive value of peak left atrial reservoir strain combined with left atrial appendage flow velocity for atrial fibrillation recurrence after pulsed field ablation.BMC cardiovascular disorders · 2026Article
- Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulation in Atrial Fibrillation Patients at Very High Risk of Stroke: A Budget Impact Analysis in Italy.Journal of clinical medicine · 2026Article
- Different approaches to persistent and long-standing persistent atrial fibrillation ablation using pulsed field ablation: impact of procedural workflows on arrhythmia termination.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Efficacy and Safety of Catheter Ablation for Atrial Arrhythmias in Solid Organ Transplant Recipients: A Single-Center Experience.Clinical cardiology · 2026Article
- Catheter Ablation for Persistent Atrial Fibrillation: Rationale, Evidence, and Contemporary Strategies Beyond Pulmonary Veins.Journal of clinical medicine · 2026Review
- Atrial Fibrillation Recurrence After Catheter Ablation Is Associated with TAG72 Protein.Journal of cardiovascular development and disease · 2026Article
- Controversy: pulsed field ablation is the standard technique for all the candidates for atrial fibrillation ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- Pulsed-field ablation beyond pulmonary vein for persistent atrial fibrillation: efficacy and impact on left atrial function.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Targeting the Substrate: Mechanism-Based Ablation Strategies for Persistent Atrial Fibrillation.Journal of clinical medicine · 2025Review
- Persistent atrial fibrillation ablation: glimpsing the light ahead?Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- Left Atrial Substrate Modification for Long-Standing Persistent Atrial Fibrillation and Left Atrial Macro- or Micro-Reentrant Tachycardia Using a Single-Shot Pulsed Field Ablation System-A Case Series.Journal of clinical medicine · 2025Article
- Catheter Ablation in Atrial Fibrillation: Recent Advances.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
26 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsRhythm control of non-paroxysmal atrial fibrillation (AF) is significantly more challenging, as a result of arrhythmia perpetuation promoting atrial substrate changes and AF maintenance. We describe a tailored ablation strategy targeting multiple left atrial (LA) sites via a pentaspline pulsed field ablation (PFA) catheter in persistent AF sustained beyond 6 months (PerAF > 6 m) and long-standing persistent AF (LSPAF). METHODS AND
resultsThe ablation protocol included the following stages: pulmonary vein antral and posterior wall isolation plus anterior roof line ablation (Stage 1); electrogram-guided substrate ablation (Stage 2); atrial tachyarrhythmia regionalization and ablation (Stage 3). Seventy-two [age:68 ± 10years, 61.1%males; AF history: 25 (18-45) months] patients with PerAF > 6 m (52.8%) and LSPAF (47.2%) underwent their first PFA via the FarapulseTM system. LA substrate ablation (Stage 1 and 2) led to AF termination in 95.8% of patients. AF organized into a left-sided atrial flutter (AFlu) in 46 (74.2%) patients. The PFA catheter was used to identify LA sites showing diastolic, low-voltage electrograms and entrainment from its splines was performed to confirm the pacing site was inside the AFlu circuit. Left AFlu termination was achieved in all cases via PFA delivery. Total procedural and LA dwell times were 112 ± 25 min and 59 ± 22 min, respectively. Major complications occurred in 2 (2.8%) patients. Single-procedure success rate was 74.6% after 14.9 ± 2.7 months of follow-up; AF-free survival was 89.2%.
conclusionIn our cohort, PFA-based AF substrate ablation led to AF termination in 95.8% of cases. Very favourable clinical outcomes were observed during >1 year of follow-up.
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